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General NPI Number Information
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NPI Number | 1548613656
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Entity Type | Individual
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Provider Name | ALYSSA MATRICCINO CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 1 OAKWOOD BLVD SUIT 130
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City | HOLLYWOOD
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State | FL
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Zip | 33020-1956
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Country | US
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Telephone | 954-925-3844
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Fax |
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Provider Business Mailing Address
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Address Line | 1 OAKWOOD BLVD SUIT 130
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City | HOLLYWOOD
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State | FL
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Zip | 33020-1956
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SZ 7581
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA15998
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License Number State | FL
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